Suturing and ligating instrument



May 3, 1932. c. B. NAGELMANN 1,856,721

SUTURING' AND LIGATING INSTRUMENT Filed Feb. 7, 1931 2 Sheets-Sheet lInueninr A llorney f/ ew E/Zye/Mm Q May 3, 1932. c. B. NAGELMANNSUTURING' AND, LIGATING INSTRUMENT Filed Feb. 7, 1931 2 Sheets-Sheet 2Inventor Czmehs' Eflge/Mawn A tlorney l atented May 3, 1932 FFICELCLEMENS B. Marmara, on BARBARA, QALIFDRNIA SUTU'RING AND IIIGATING"INSTRUMENT A-ppIication filed February 7, 1931'.

This invention relates to a suturing and ligating instrument and has foran important object to provide, in a manner as hereinafter set forth, adevice of this character embodying a' novel construction and arrangementof parts whereby thesame may be successfully used in comparativelyinaccessible places, as in the throat of a patient who has undergone anoperation for the removal of the tonsils.

Another important object of the invention is to provide a surgicalinstrument of the character described embodying means forexpeditiouslytying a ligature with a non-slip knot to a bleeding blood vessel in amanner to stop the flow of the blood.

Other objects of the invention are to provide a device of the characterset forth which will be simple in construction, strong, durable,efficient and reliable in operation and which may be manufactured at lowcost.

All of the foregoing and still further objects and advantages of theinvention may become apparent from a study of the followingspecification, taken in connection with the i accompanying drawingswherein like characters of reference designate corresponding partsthroughout the several views, and wherein Figure l is a perspective viewof a suturing T and ligating instrument constructed in accordance withthis invention.

Figure 2 is a fragmentary view on an enlarged scale in perspectiveshowing the arrangement of the ligature on the instrument prior to theoperation of the device.

Figure 3- is a fragmentary detail view on an enlarged scale and in sideelevation showing the needle latch in retracted or inoperative position.

Figures 4; to 10; inclusive, show progressively the formation of theknot which is tied in the ligature by the instrument constituting thisinvention.

Referring to the drawings in detail, it will be seen that the referencenumerals 1- and 2 designate a pair of levers which are crossed andpivotally connected asat 3, oneend portion of the leversl and 2 areformed to provide actuating handles-4 and 5, respectively.

What will be hereinafter referred toas a serial No. 511E233;

needlestripping bar is designated by the reference numeral- 6' and saidstrlpplng. bar is mounted for swinging movementon the pivot screw orpin-3- and is provided with an end portion which isoperable between thelevers 1 and 2-. Said end portion is designated by the reference numeral7. Formed in the outer portion of the endportion 7 of the stripping bar6 are the spaced openings 8 and 9 the purpose of which will be presentlyset forth.- Theother endportion-of the stripping bar 6 is formed-toprovide a handle-portion lOand mounted on said other end portion on theinnerside thereof is a detent '11 which is adapted for engagementin arecess 12 which is provided in the inner side of the handle portionof-th'e lever 2 for locking said lever 2 and the stripping bar 6together for movement in unison for a purpose which also will bepresently set fort.

The-outer end portion of the lever 2 is provided with an opening. whichis intersected by a groove or channelilt wh-ichg isprovided in the sideof' said lever 2 which is opposed to'the end portion 7 ofthe stripping.bar 6. The opening 13 is for the reception of aneedle 15 which isrigidly securedon tlie opposed side of the lever 1 said needle 15- beingslidably operablethrou-gh the opening Sin-the end portion 7 of thestripping bar 6'. The need-le 1-5 isflat on its lower side and-hasformed integrally on its free end portion a hook 1-6, Aresilientlatch 17is mounted on the lever 1- and" is also operable'through the opening 8in the end portion 7 of the stripping bar 6 inamanner'to permit its-freeend toabut the hoolrlGof the needle l5, the latch 17 being adapted; forsliding engagement with the flat side of the=needle;15 ,vas'illustratedto advantage in- Fi-gure2 ofthe drawings.

The needle 17. is provided with an offset portiorr 1 8- which isspacedfrom the lever l and which isengageable' by the end portion 7 ofthe stripping barG todisenga-ge'thesaid latch-17 from the book 16,:asalso seenin-Figure 2 of the drawingsperipherally grooved pulley 19 isjournaledim the lever 2 adjacent the hole 18, saidpu'lley I9- beingdisposed in a slot 20 provided therefor in the lever 2.

The ligature is designated by the reference numeral 21 and, in use, islooped in the manner illustrated in Figure 1 of the drawings and thendisposed over or around the needle 15 and the latch 17 in the mannerindicated in broken lines in Figure 2 of the drawings. One end portionof the ligature 21 is inserted in the groove or channel 1 1 in the lever2 in a manner to traverse the opening 13. The other end portion of theligature is trained around the pulley 19 and is inserted through theopening 9 in the end portion 7 of the stripping bar 6 and then tied orotherwise secured to the lever 1. The tissue to be ligated is dis posedbetween the pointed end of the needle 15 and the outer end portion ofthe lever 2 and the levers 1 and 2 are then moved toward each otherthrough the medium of the handles 1 and in an obvious manner to causethe needle to penetrate the tissue and enter the opening 13 in the lever2. Continued closing movement of the levers 1 and 2 will engage the endportion 7 of the stripping bar 6 with the offset portion 18 of the latch17 F: and said latch will be moved to open or inoperative position outof engagement with the hook 16 of the needle 15. It may be well to herestate that the needle 15 passes above the end portion of the ligature 21which extends across the opening 13 and when the latch 17 is disengagedfrom the hook 16 said end portion of the ligature enters the hook 16.The detent 11 is engaged in the recess 12 in the handle portion of thelever 2 to lock the stripping bar 6 and said lever 2 together. Thelevers 1 and 2 are then moved away from each other or opened in a mannerto withdraw the needle 15 from the opening 13 with the ligature 21secured in the hook 16. lVhen the lever 1 begins to move away from thelever 2 the end portion 7 of the stripping bar 6 is, of course,disengaged from the offset portion 18 of the latch 17 and said latch isthus permitted to return to its operative position in engagement withthe hook 16. The needle 15 with the ligature attached thereto iswithdrawn from the tissue and the opening 8 of the strippin bar 6, thestripping bar 6 functioning to slip the ligature 21 and the tissue whichis being ligated off of the needle 15. The needle 15 draws the ligaturethrough the tissue and the loop or preformed knot which has been formedin the ligature. As the lever 1 moves away from the lever 2 thepreformed knot which is designated by the reference numeral 23 isprogressively tightened on the end portion of the ligature which hasbeen drawn thereto by the needle 15 by reason of the fact that the otherend portion of the ligature 21 is secured to the lever 1. In Figures 5to 9, inclusive, of the drawings the tissue is designated by thereference numeral 24. The end portion of the ligature 21 which issecured to the lever 1 is designated by the reference numeral 25 and theother end portion of the ligature which is drawn through the preformedknot 23 by the needle 15 is designated by the reference numeral 26.l/Vhen a ligating operation has been performed with an instrument inaccordance with this invention, a square, non-slip knot as illustratedin Figures 9 and 10 of the drawings is formed.

It is believed that the many advantages of a suturing and ligatinginstrument in accord ance with this invention will be readilyunderstood, and, although the preferred embodiment of the invention isas illustrated and described, it is to be understood that changes in thedetails of construction may be had which will fall within the scope ofthe invention as claimed.

What is claimed is 1. A suturing and ligating instrument comprising apair of crossed, pivotally connected levers for swinging movement towardand away from each other, a tissue penetrating needle on the free endportion of one of the levers for supporting a ligature, said ligaturebeing looped around the needle in a manner to provide a preformed knot,the free end portion of the other lever having an opening for thereception of the needle after said needle has penetrated the tissue,means on said other lever for releasably supporting one end portion ofthe ligature thereon across the opening therein for engagement by andconnection with the needle when said needle enters the opening, saidneedle drawing the ligature through the tissue and the knot when thelevers are swung away from each other, said ligature having its otherend portion slidably engaged with said other lever and anchored to saidone lever in a manner to tighten the knot on said one end portion of theligature when the levers are swung away from each other, and actuatinghandles on the pivoted end portions of the levers.

2. A suturing and ligating instrument comprising a pair of crossed,pivotally connected levers for swinging movement toward and away fromeach other, a tissue penetrating needle on the free end portion of oneof the levers for supporting a ligature, said ligature being loopedaround the needle in a manner to provide a preformed knot, a hook on thepointed end portion of the needle, the free end portion of the otherlever having an opening for the reception of the needle after saidneedle has penetrated the tissue, the free end portion of said otherlever being further provided with a groove in the side thereof which isopposed to said one lever for the reception of one end portion of theligature for releasably supporting said one end portion of the ligatureon said other lever across the opening therein for engagement by thehook when the needle enters the opening for securing said one endportion of the ligature to the needle, said needle drawing the ligaturethrough the tissue and the knot when the levers are swung away from eachother, a pulley journaled on said other lever, the other end portion ofthe ligature being trained over the pulley and anchored to said onelever in a manner to tighten the knot on said one end portion of theligature when the levers are swung away from each other, actuatinghandles on the pivoted end portions oi the levers.

3. A suturing and ligating instrument comprising a pair of crossed,pivotally connected levers for swinging movement toward and away fromeach other, a tissue penetrating needle on the free end portion of oneof the levers for supporting a ligature, said ligature being loopedaround the needle in a mannor to provide a preformed knot, a hook on thepointed end portion of the needle, the free end portion of the otherlever having an opening for the reception of the needle after saidneedle has penetrated the tissue, the free end portion of said otherlever being further provided with a groove in the side thereof which isopposed to said one lever for the reception of one end portion of theligature for releasably supporting said one end portion of the ligatureon said other lever across the openin therein for engagement by the hookwhen the needle enters the opening for securing said one end portion ofthe liga ure to the needle, said needle drawing the ligature through thetissue and the knot when the levers are swung away from each other, apulley journaled on said other lever, the other end portion of theligature being trained over the pulley and anchored to said one lever ina manner to tighten the knot on said one end portion of the ligaturewhen the levers are swung away from each other, actuating handles on thepivoted end portions of the levers, a resilient latch mounted on saidone lever and engageable with. the hook on the needle, and means fordisengaging the latch from the hook when the needle is pass ing into theopening in said other lever.

4. A suturing and ligating instrument comprising a pair of crossed,pivotally connected levers for swinging movement toward and away fromeach other, a tissue penetrating needle on the free end portion of oneof the levers for supporting a ligature, said ligature being loopedaround the needle in a manner to provide a preformed knot, a hook on thepointed end portion of the needle, the free end portion of the otherlever having an opening for the reception of the needle after saidneedle has penetrated the tissue, the free end portion of said otherlever being further provided with a groove in the side thereof which isopposed to said one lever for the reception of one end portion of theligature for releasably supporting said one end por tion of the ligatureon said other lever across the opening therein for engagement by thehook when the needle enters the opening for securing said one endportion of the ligature to the needle, said needle-drawingthe ligaturethroughthe tissue and the knot when the lovers are swung away from eachother, a pulley journaled on said other lever, the other end portion. ofthe ligature being trained over the pulley and anchored to saidone-lever in a manner to tighten the knot on said one end portion ofthe-ligature when the levers are swung away from each other, actuatinghandles on the pivoted end portions the levers, a resilient latchmounted. on said one lever and engageable with the hook on the needle,and means for disengaging the latch from the hook when the needle ispassing into the opening in said other lever, said means comprising apivoted bar having an end portion disposed for swinging movement betweenthe levers, said end portions being provided with an opening, theneedlea-nd the latch extending slidaoly through the opening, said barengageable with the latch ina manner to disengage said latch from thehook.

A: suturing and ligating instrument conrprisinga pair of crossed,pivotally connected levers for swinging movement toward and away fromeach other, a tissue penetrating needle on the free end portion of oneof the levers for supporting a ligature, said ligature being loopedaround the needle in a manner to provide a preformed knot, a hook on thepointed end portion of the needle, the free end portion of the otherlever having an opening for the reception of the needle after saidneedle has penetrated the tissue, the free end portion of said otherlever being further provided with a groove in the side thereof which isopposed to said one lever for the reception of one end portion of theligature for releasably supporting said one end portion of the ligatureon said other lever across the opening therein for engagement by thehook when the needle enters the opening for securing said one endportion of the ligature to the needle, said needle drawing the ligaturethrough the tissue and the knot when the levers are swung away from eachother, a pulley journaled on said other lever, the other end portion ofthe ligature being trained over the pulley and anchored to said onelever in a manner to tighten the knot on said one end portion of theligature when the levers are swung away from each other, actuatinghandles on the pivoted end portions of the levers, a resilient latchmounted on said one lever and engageable with the hook on the needle,and means for disengaging the latch from the hook when the needle ispassing into the opening in said other lever, said means comprising apivoted bar having an end portion disposed for swinging movement betweenthe levers, said end portions being provided with an opening, the needleand the latch extending slidably through the opening, said barengageable with the latch in a manner to disengage said latch from thehook, means for securing the bar to said other lever for swingingmovement in unison therewith for stripping the knot and the tissue fromthe needle when the levers are swung away from each other.

6. A suturing and ligating instrument comprising a pair of pivotallyconnected levers, a needle on one of the levers, the other of the levershaving an opening for the re ception of the needle, coacting means onthe levers for supporting and tying a ligature, and a lever pivotallymounted on the first named levers and operatively engaged with theneedle for removing the ligature'therefrom after said ligature has beentied.

7. A suturing and ligating instrument comprising a pair of pivotallyconnected levers, a needle on one of the levers, the other of the levershaving an opening for the reception of the needle, ooacting means on thelevers for supporting and tying a ligature, and a lever pivotallymounted on the first named levers and operatively engaged with theneedle for removing the ligature therefrom after said ligature has beentied, the third named lever having an opening therein through which theneedle projects and in which said needle is operable.

In testimony whereof I aliix my signature.

CLEMENS B. NAGELMANN.

